A large multi-country trial in Africa found that adolescents with HIV maintained viral suppression better with long-acting injectable therapy every eight weeks than with daily oral tablets over 96 weeks.

In South Africa, adolescents switching to the long-acting cabotegravir–rilpivirine injections achieved sustained viral suppression by week 48, with 95.5% below 50 copies/mL and no confirmed virologic failure.

The LATA trial enrolled 476 young people aged 12 to 19 who were already virally suppressed on tablets and had no prior treatment failures, with injections given every eight weeks after more than a year on tablets.

Context: the study was conducted as a clinical trial with research resources and participant compensation, which may limit generalizability to routine clinics; pre-treatment drug resistance testing was not performed.

The study, led by researchers from the University of Cape Town and published in The Lancet on September 24, 2026, was funded by Johnson & Johnson and other sponsors, with disclosures of various industry honoraria; AI-assisted editorial tools were noted.

Safety: injection-site reactions were common but mostly mild to moderate, with early pain or tenderness; one grade 3 infection resolved with antibiotics; no drug-related adverse events caused discontinuation; two serious adverse events occurred but were not linked to the study drugs.

Access barriers persist: long-acting injectables remain limited in lower-resource settings due to patents, higher costs, thermal refrigeration needs, and requirement for trained nursing staff compared with tablets.

Funding and sponsorship: the trial was supported by the EU through EDCTP-2 and Johnson & Johnson Innovative Medicines, with ViiV Healthcare supplying rilpivirine and Janssen providing cabotegravir; University College London served as sponsor.

The Lancet findings indicate injections may be at least as effective as tablets and potentially more effective for adolescents, a group historically at higher risk of poor adherence.

Implications: exceptionally high viral suppression and retention suggest LAI-ART could transform outcomes for adolescents struggling with engagement in care, though real-world effectiveness needs further study.

Study design: a nonrandomized, single-arm Cape Town study enrolled 134 participants aged 12–24 with a mix of suppression status and adherence challenges.

Viral rebound was very low on injections (1%) versus tablets (6%), signaling superior suppression with the injectable regimen in this age group.